Timely diagnostics of the early stages of fibrosis in chronic hepatitis C infection and the possibility to control it in patients with liver cirrhosis remains a topical issue in modern medicine. Hyaluronic acid (HA) takes a special place among direct hepatic fibrosis markers and is largely related to fibrogenesis, but is also involved in fibrinolysis, reflecting extra-cellular matrix remodeling. The aim of our research is to specify hepatic fibrosis diagnostics in patients with chronic hepatitis C infection through determination of gender and age peculiarities of the hyaluronic acid level in the blood serum. 66 patients with CHC of the 1st virus genotype have been examined. The diagnosis is confirmed by PCR results (RNA HCV +). The control group included 21 healthy individuals. The patients were also distributed by age and gender. All patients and control group individuals underwent ultra-sound fibroesophagography using FibroScan device. The results of fibroesophagography were evaluated by the METAVIR scale. The level of HA in the blood serum was determined both for patients with CHC and control group individuals with a set ‘HyaluronicAcid’ (Corgenix, Inc., the USA)). Statistical processing of the results was carried out in the statistical package “STATISTICA 5.5” (licensed number AXXR 910А374605FA). A method of correlation-regression analysis was used to develop a model of the dependence of the level of GA (on the duration (stage) of triple antiviral therapy). The validity of the difference between the comparable sample results was carried out according to the Student's criterion. Revealed that the level of HA in the blood serum of patients with CHC was higher than in the group of healthy individuals. The HA level in the blood serum of patients with CHC of the younger age group was lower than in people of the older age group. The analysis made by us showed that the HA level in the blood serum of patients with CHC increased in correspondence with the intensification of fibrotic changes in liver tissue in both age groups. So, a tendency was traced to the increase of HA in the blood serum of patients with CHC as compared to healthy individuals (2.61 times in the younger age group and 2.82 times — in the older age group), as well as, respectively, intensification of fibrotic changes in liver tissue in both age groups (2.03–4.26 times in the younger age group and 2.15–4.83 — in the older age group). No reliable difference between the levels of HA in the blood serum of patients with CHC depending on the gender has been traced.

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Chronic hepatitis C (CHC) is not only a serious medical problem all over the world but it is also accompanied with a range of social problems, among which the most complicated for patients is stigmatization and discrimination. Main causes of occurrence of such notion are the lack of understanding of peculiarities of the disease and a great number of myths about the ways of transmission of this disease. Therefore, a chain of negative consequences occur, which results in decreased self-esteem, complexes, depression of such kind of patients and considerably worsen the quality of life of a patient with CHC. The purpose of this work was to investigate the prevalence of external stigma and to determine with which its species are most commonly found in patients with HCG. Identify the most common causes of its occurrence, establish a link between stigma and duration of the disease, and analyze possible ways to overcome this phenomenon in order to improve the quality of life of patients with CSF. The article introduces the results of the research on the spread of external stigma and definition of its types in 316 patients with CHC, among them males 178 (56.32%), females 138 (43.67%), aged 18 to 65, before the beginning of treatment of patients with medications of direct antiviral action. It was set, that 168 out of 316 patients with CHC confirmed the fact of stigma from the side of surrounding people, what made up (53.16%). Direct dependence between CHC and frequency of stigmatization was found out. It was set that most often patients with stigma occurred in such fields as social (39%), family life (31%), medical aid services (21%) and other types of stigma (8%). Therefore, stigmatization and discrimination of patients with CHC is not only extremely negative social notion but also serious human rights violation. In the opinion of the authors current issue can be overcome only by means of cardinal change of attitude of the society towards it. Thus, it is necessary to create a single algorithm of treatment of CHC patients which will include large scale educational projects aiming to deepen understanding of epidemiological and clinical peculiarities of this disease. These projects have to involve patients and their family members, as well as those who provide medical services and society members on the whole. Consequently, it will lead to a reduction of stigmatization of CHC patients, improvement the quality of their life, decrease of the morbidity level and occurrence of negative consequences.

Objectives: The aim of this study was to determine the predictive role of TLR4 polymorphism in CAP course among young cytomegalovirus-positive patients. Subjects and Methods: One hundred and five patients with pneumonia (age range: 18–44 years) and 61 healthy respondents were observed clinically and specifically (by cytomegalovirus markers and TLR4 + 3725 G/C polymorphism). Results: Among CAP patients, there were 51 male (48.6%) and 54 female (51.4%), with average age 34.1 ± 0.8 years, and there were 19 (18.1%) patients with Pneumonia Patient Outcomes Research Team (PORT) I, 46 (43.8%) patients with PORT II, 31 (29.5%) patients with PORT III, and 9 (8.6%) patients with PORT IV. Cytomegalovirus persistence was detected in 80 (48.2%) patients and 34 (20.5%) healthy respondents ( P = 0.003). G/G genotype of TLR4 signaling was found in 78 (74%) patients with pneumonia, G/C in 24 (23%) patients, and C/C in 3 (3%) patients. Among G/C patients, there were 16.2% cytomegalovirus-positive patients versus 6.7% negative patients ( P < 0.05), as well as among G/G patients, and there were 59% versus 15,2%, accordingly ( P < 0.01). The patients of the main group with G/G genotype were characterized by mostly mild (PORT I – 15 [14.3%]) and moderate pneumonia severity (PORT II – 32 [30.5%] and PORT III – 26 [24.8%] patients). The patients with G/C genotype were characterized by mostly PORT II (11 [10.5%] patients). All C/C genotype patients have PORT II ( P < 0.05). Conclusions: Cytomegalovirus persistence worsens the pneumonia course. G/G and G/C TLR4 genotypes are associated with mild pneumonia severity.

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